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VICTORIAN SQUARE, LLC

Assisted Living, Mental Illness

Rockwood, Tennessee

Provider NPI: 1710180955

Organization Information:
Organization Name:  VICTORIAN SQUARE, LLC


Practice Location:
241 S CHAMBERLAIN AVE  ROCKWOOD, TN 37854 US
Tel: 865-354-1133  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Mental Illness
TNACL0000000147

Other Provider Identifiers:

IssuerNumberStateType
TENNCARE/MEDICAID4262690TN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTAL ILLNESS JOBS TN - Page 1